The late-onset risk of breast implant-associated anaplastic large-cell lymphoma made the Food and Drug Administration request Allergan to voluntarily recall implants from the global market. As Allergan implants are the only approved breast implants in Japan, the emergency was referred to as the "Allergan Crisis" . Emergency information about the recall should be provided to patients; however, the Japan Oncoplastic Breast Surgery Society did not provide detailed methods for doing this. We chose to mail our own documents to the patients as soon as possible. We retrospectively surveyed the effects of the mail announcement method and analyzed the response of patients. Seventy-two patients were informed by mail and 11 patients (15%) changed their outpatient appointment to an earlier time to obtain the information from doctors directly. Sixteen patients (22%) exhibited anxiety and 4 patients elected to remove their breast implants. Surgeries included the removal of the capsule tissue around the implants, with the exception of the tissue on the thoracic wall side to avoid causing pneumothorax. No complications (e.g., hematoma or infection) were observed. It should be assumed that similar recalls may occur when breast reconstruction is performed using artificial materials. We provided prompt information, which aided in patient decision-making.

[introduction] The purpose of this study was to investigate factors related to acute pain after breast reconstruction using a tissue expander. [method and results] Thirty-five patients were administered a questionnaire survey about postoperative pain and divided into 2 groups according to the degree of postoperative pain. The relationship between the degree of postoperative pain and 9 factors related to pain was evaluated. [conclusion] Univariate analysis demonstrated postoperative acute pain to be significantly related to BMI, the presence of lateral pocket reconstruction, and initial injection volume. Our study revealed that in low BMI patients, postoperative acute pain can be reduced by increasing the initial injection volume into the expander and avoiding LP reconstruction. However, considering safety precautions against infection, not all cases can be addressed using this policy. Further investigation and solutions may be needed in the future.

We investigated the design of flaps, intraoperative ICG angiography findings, reconstruction methods, and complications in 13 patients with caesarean section scar who underwent breast reconstruction using TRAM or DIEP. In patients with midline scars, blood flow to the caudal area in zone II was poor. We were able to perform breast reconstruction using a flap with a sufficient volume and design employing the supercharged or in-flap anastomosis technique based on the intraoperative ICG angiography findings.

Total mastectomy is the surgery of choice for ipsilateral breast tumor recurrence after breast-conserving therapy; however, there are issues to consider such as reconstruction being performed after radiotherapy. In this study, we included patients who underwent total mastectomy and breast reconstruction due to ipsilateral breast tumor recurrence after breast-conserving therapy between 2005 and 2019, and evaluated complications associated with the reconstruction and countermeasures. There were 35 patients (36 breasts) , and 18 (19 breasts) and 17 underwent reconstruction with artificial materials and autologous tissues, respectively. Complications requiring surgery under general anesthesia were observed in 4 patients who underwent artificial reconstruction, and the width of skin resection at the time of total mastectomy for residual breast tissue significantly affected the onset (p=0.0265) . There is a need for an effective reconstruction method and surgical technique for total mastectomy and reconstruction after breast-conserving therapy while keeping factors like skin resection and established post-radiotherapy risks in mind.